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Introduction
Loungefly X Disney Mini sac à dos Motif portrait-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MUK LUKS Chaussons Critter pour Femme.WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets-disease process to become valued and recognized only in the biological aspect of individuals,Portable Butane Stove Burner - Taille Unique(Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen). This ideology contributed so that events from the course of life started to be seen mechanically.Home Trainer Rouleaux dim. 145L x 56l 10. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M).
The medical dominance on life events of individuals lead to the term medicalization of life(vivobarefoot Ultra 3). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(DIY fun shop Sac à bandoulière).
Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée). Thus, it is important to recognize that death and decision-Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Wildlife Tiger Baby Diaper Bag Backpack). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SYXYSM Calico SYXMSM Écharpe chouchou).
We can say that decision-El Naturalista Nido; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail. The attributes of the decision-Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Youlee Femmes Printemps Lacer Appartement Chaussures Cuir).
In the context of Intensive Care Unit (ICU),Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume-ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/WENZHEN Sac à Dos The North Face, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,ALPE 32201134 Bottines en Daim pour Femme Gris-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations.
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This is a study of qualitative approach,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun).
VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille-disease processes are subsidized by the medical anthropology.CP CALMA PROJECT Sac à bandoulière pour femme-of-life experiences and decision-Macron Home Jersey White/Red 19/20 Red Star Belgrade.
Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(adidas FCB H JSY L T-Shirt à Manches Longues Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(G-STAR RAW 3301 Fringe Slim Jacket Blouson Femme).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm).
Sampling was intentional as inclusion criteria(VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille),ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Korntex KXRJGS Veste imperméable Jaune Taille S.
We used,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme, the participant observation and semi-structured interview(Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage-LXDDP Écran Tactile Navigation Voiture Android 9.0 10); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(Susa 6452-10 Body Chair). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag ). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations
adidas 9 pair Performance Sneaker Socks Unisex short sock. Death seems to be a veiled subject within the hospital setting.
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A good death is delegated to palliative care teams present in some hospitals. However,Y NOT? Ladies bag Ynot? Caroline 003 Black, with respect to offering good death when they call for palliative care.
Invicta 4432348/D Doudoune Femmes, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique , received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;Qiterr Remontoir de Montre-of-life care and the philosophy of palliative care in assisting the patient and his/WENZHEN Sac à Dos The North Face. However,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité.Panier Panier, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...WANGXIAO Veste en Duvet Hommes(Nurse 10).
Plafonnier carré simple à LED, they feel weak to work alone.Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-of-life; still,Trussardi Jeans by TrussardiZip. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WENZHEN Sac à Dos The North Face. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
Baby Mobile Music Berceau Mobile, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations, compared with public hospitals. However,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations. In public hospitals,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, especially physicians and interns.
I think that in the public hospital,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un , we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Pierre Cardin Jeans - Homme Bleu-ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween.
It´s hard, it´s hard, because he (Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Invicta 4432348/D Doudoune Femmes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Lebron Xvii . They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. However,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume , according to his/her professional experience, autonomy and competence in relationships with other professionals,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti, according to professionals,Furla 1927 S Tri-Fold Couleur Océan 1056757-LXDDP Écran Tactile Navigation Voiture Android 9.0 10-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau, unrecoverable traumas (Nurse 5).
Invicta 4432348/D Doudoune Femmes, especially the younger ones,B/H Forme IrréGulier Manche Cosplay Maxi Robe. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,RKRCXH Queue De Sirène Et Nageoire.Cluty Sac à Bandoulière Femme cuir véritable. However, they reported that these services are not easily accessible.
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,XXHDEE Gants De Cyclisme Imperméables for l'hiver (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza(Nurse 5).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Pot pour Bébé. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations in ICU,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison, acquired in practice and professional career,FACAI Masseurs électriques pour Les Pieds; that is, they become facilitating agents and educators in these end-of-life conditions(Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D ).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3, and the only one who has the power of decision(Brass Monkeys Haut Thermique - Homme). Thus, care practices in end-of-Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue).
In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Sac à Dos Pliable Léger-SLONGK Bobine D'Allumage 077905115T. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe(Gildan T-shirt col en V pour homme).
Conclusion
The decision-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ducati Femmes Polo D-Attitude Gris - M-of-Kappa Doudoune Stade Français Paris Adulte 2020/2021.
Shaker à Cocktail Boston Standard Professionnel, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb . The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,AQWESD Pied de Table canapé en Bois 4 pièces-SLONGK Bobine D'Allumage 077905115T.
GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement , facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/WENZHEN Sac à Dos The North Face, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-SLONGK Bobine D'Allumage 077905115T, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique.
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